Healthcare Provider Details

I. General information

NPI: 1003344110
Provider Name (Legal Business Name): MICHAEL CHARLES O'LAUGHLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 CROSSROADS DR STE 410
OWINGS MILLS MD
21117-5491
US

IV. Provider business mailing address

23 CROSSROADS DR STE 410
OWINGS MILLS MD
21117-5491
US

V. Phone/Fax

Practice location:
  • Phone: 410-581-0700
  • Fax: 410-469-5690
Mailing address:
  • Phone: 410-581-0700
  • Fax: 410-469-5690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2026027957
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number41007
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0094810
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: